Comparison of Accuracy in Expert Clinical Examination versusMagnetic Resonance Imaging and Arthroscopic Exam inDiagnosis of Meniscal Tear

Many clinical tests and diagnostic studies have been developed to increase the clinician’s ability to accuratelydiagnose disorders of the knee. Torn menisci or ligamentous structures within the knee cause significant pain and disability andthus require expeditious management. +is study was conducted to evaluate the accuracy of clinical examination in comparisonwith MRI examination and with the help of arthroscopic examination as the gold standard in the diagnosis of meniscal tears.Method. All of the arthroscopic surgery candidates, presenting symptoms of meniscal or cruciate ligament lesions, referring toNamazi and Chamran hospitals, Shiraz, Iran, were included in this study. Clinical examination (including McMurray test, Apleytest, and 20 +essaly test) was performed before the arthroscopy, and the results were recorded in special forms. Magneticresonance imaging (MRI) results were also added. +en, arthroscopy was performed, declaring the definite diagnosis, and theresults were compared to the results obtained from both tests and MRI. Statistical analysis was performed using SPSS software.Results. 86 patients with a mean age of 27 years old, including 63 (73%) male and 23 (27%) female, were studied. 57 (66%), 19(22%), and 10 (12%) injuries were caused by sports, twisting, or trauma, respectively. Arthroscopic results showed 32 meniscaltears, of which 28 (87%) and 4 (13%) were in medial and lateral menisci, respectively, including 10 bucket handle, 17 longitudinal,and 5 of other types (transverse, oblique, radial) of injuries. Comparing MRI results to arthroscopic results, we had 2 false-positiveand 2 false-negative cases. 62 cases of McMurray test results were accurate; 15 and 9 cases were reported false positive and falsenegative, respectively. 60 cases of Apley test results were accurate; 16 and 10 cases were reported false positive and false negative,respectively. 78 cases of +essaly test results were accurate; 5 and 3 cases were reported false positive and false negative, re-spectively. Comparing +essaly test results to McMurray and Apley showed statistical significance (P<0.05). Comparing +essalytest results to MRI showed no statistical significance (P�0.151), while comparing McMurray and Apley test results to MRIshowed statistical significance (P<0.01).Conclusion. Clinical examination, performed by an experienced examiner, can haveequal or even more diagnostic accuracy compared to MRI to evaluate meniscal lesions. In this study, the +essaly test has beenapproved as a reliable clinical test in the diagnosis of meniscal tears